1. Health Care and Social Assistance of an Ageing Society in Poland - characteristics and trends Berlin SCORUS Meeting, 29 - 31 March 2010 Relations between Generations and the Challenges of an Ageing Society Anna Jasiówka, Marta Pompa, Monika Wałaszek

2. PLAN OF THE PRESENTATION 1. Ageing society in Poland: Demographic characteristics Demographic predictions (Central Statistical Office, United Nations) Comparison with Europe and rest of the world 2. Future changes in both health care and social assistance areas related to ageing of the Polish society - results of the forecast model: Estimation of an expected number of physicians Estimation of an expected number of nurses Estimation of an expected number of residents of stationary social welfare facilities Estimation of expenditure on social assistance

3. Source: Central Statistical Office of Poland PEOPLE OVER 65 AND CHILDREN BELOW 14 IN POLAND

4. VITAL STATISTICS OF POLISH POPULATION Source: Central Statistical Office of Poland

5. LIFE EXPETANCY AT BIRTH Source: United Nations

6. RATIO OF PEOPLE OVER 65 TO THE TOTAL POPULATION Source: United Nations

7. CONCLUSIONS FOR POLISH SOCIETY Beginning from 2015 new trends will be observed: The number of live births will be lower than the number of deaths The number of people at the age of at least 65 will be higher than the number of children

8. The goal was to create a regression model, based on available data, in order to estimate the expected number of physicians and nurses in the future Because there is not enough data required to build an appropriate estimation model and there are hardly measurable qualitative data, we make the regression model by using two independent variables, which described the dependent variable (physicians, midwives) in the best possible way To obtain estimated value of dependent variable in the future, we used the CSO data on the population projection MODEL ASSUMPTION

9. PHYSICIANS = 3,53 * PEOPLE + 0,74 * NET MIGRATION Standard error of estimation Corrected R 2 0,97 BETA St. Error BETA B indicator St. Error Bp level Net migration0,230,070,740,210,00 People 15 -641,200,073,530,190,00 11 335 REGRESSION MODEL FOR PHYSICIANS

10. Standard error of estimation Corrected R 2 0,98 18 674 NURESES=0,0004*PEOPLE 2 +4 833*NET MIGRATION+ 105*NET MIGRATION 2 BETA St. Error BETA B indicatorSt. Error Bp level Net migration 0,650,144 8331 0800,00 Net migration 2 0,370,1105,8280,00 People 15-64 2 1,290,060,00040,000020,00 REGRESSION MODEL FOR NURSES

11. Total number People per one People over 65 per one Consulations per one physician Physicians now 82 828460621 823 in 2010 79 267480651 944 in 2015 83 918453701 869 Nurses now 197 45219326- in 2010 215 28917724- in 2015 212 09017928- ESTIMATION OUTCOMES

12. ESTIMATED NUMBER OF PEOPLE PER ONE PHYSICIAN

13. BETA St. Error BETA B indicator St. Error Bp level People over 441,230,020,00750,000110,00 People 0 - 17-0,240,02-0,00230,00020,00 Standard error of estimation Corrected R 2 0,99 1 333 RESIDENS=0,0075*PEOPLE44 + -0,0023*PEOPLE 0-17 REGRESSION MODEL FOR RESIDENTS

14. People 65+ People 15 - 64 %GDP People 65+ People 15 - 64 %social expenditure Social expenditure for old people per capita PREDICTION MODEL FOR SOCIAL EXPENDITURE

15. Standard error of estimation 141 Corrected R 2 0,99 BETA St. Error BETA B indicatorSt. Error Bp level %GDP 2 0,260,111 077,44570,00 %SOCIAL EXPENDITURE 0,730,11146 641,622 3580,00 EXPENDITURE=1 077,4*%GDP 2 +146 641,6*% SOCIAL EXPENDITURE REGRESSION MODEL FOR EXPENDITURE

16. Total number Employed Residents now 98 42455 127 in 2010 101 33356 929 in 2015 104 78658 869 Per capitaTotal Per one people 18 – 60/65 Expenditure now 2 37190 4663 707 in 2010 2 43092 5683 767 in 2015 2 15181 7773 448 ESTIMATION OUTCOMES

17. OUTCOMES OF CORRESPONDANCE ANALYSIS IN THE AREA OF DISABILITY Source: Central Statistical Office of Poland

18. OUTCOMES OF CORRESPONDANCE ANALYSIS FOR LONG-TERM HEALTH PROBLEMS AND CHRONIC DISEASES Source: Central Statistical Office of Poland

19. OUTCOMES OF CORRESPONDANCE ANALYSIS FOR DISEASES AND AGE Source: Central Statistical Office of Poland

20. Although the projected number of physicians will increase, one physician will give more medical consultations during a year than nowadays. It will be mainly a result of changes in the age structure of Polish population. Disparity between the voivodships will be observed when it comes to workload of physicians. It will be related to the expected number of old people different in each voivodship and greater health needs of these people. Increasing number of nurses may be insufficient to meet the needs of an aging population. CONCLUSIONS (1)

21. A group of people with long-term health problems, chronic diseases and disability which require greater medical care, will raise. It may cause, that increasing number of nurses will be insufficient. Increasing number of patients in institutions of social assistance will require raise the employment in these organization, if the standard workload of employees will be maintained. Otherwise it may lead to decline in service quality. The financial resources allocated to social assistance will be reduced which mainly come from the state budget. It will be a result of dwindling stocks of economically active people. CONCLUSIONS (2)

22. THANK YOU FOR YOUR ATTENTION A.Jasiowka@stat.gov.pl, M.Pompa@stat.gov.pl, M.Walaszek@stat.gov.pl